Abstract
Medical imaging often presents objects in three-dimensional (3D) form to provide better visual understanding. In contrast, histopathology is typically presented as two-dimensional (2D). Our objective was to present the tumor dimensions in 3D by creating a 3D digital model of it and so demonstrate the location of the tumor and the histological slices within the surgical soft tissue resection specimen. We developed a novel method for modeling a tongue squamous cell carcinoma using commonly available instruments. We established our 3D-modeling method by recognizing and solving challenges that concern the selection of the direction of histological slices. Additional steps to standard handling included scanning the specimen prior to grossing and modeling the carcinoma, which required only a table scanner and modeling software. We present challenges and their solutions in modeling the resection specimen and its histological slices. We introduce a finished 3D model of a soft tissue resection specimen and the actual tumor as well as its histopathological grossing sites in 3D digital and printed form. Our novel method provides steps to create a digital model of soft tissue resection specimen and the tumor within. To our knowledge, this is the first attempt to present histopathological margins of a tongue tumor in 3D form, whereas previously, only 2D has been available. The creation of the 3D model does not call for predetermined grossing directions for the pathologist. In addition, it provides a crucial initiative to enhance oncological management. The method allows a better visual understanding of tumor margins, topography, and orientation. It thus provides a tool for an improved postoperative assessment and aids, for example, in the discussion of the need for additional surgery and adjuvant therapy.
Highlights
Three-dimensional (3D) presentation of various objects is common in engineering sciences and in medical imaging to enhance visual understanding of the object
A few experiments have addressed this issue. These include two different methods to create a 3D representation of the tumor by creating a model, either from a series of 2D histological slides from the resection specimen or from preoperative 2D medical images. The former method has been used in modeling colorectal carcinoma and liver [1,2], radical prostatectomy [3,4], and bladder reconstruction [5], and the latter method for modeling lungs [6], breast cancer [7], pancreatic ductal adenocarcinoma [8], rectal cancer [9], and ghost cell odontogenic carcinoma [10]
An introductory video of the results can be seen at https://drive.google.com/file/d/19CdUuhDwPED5L3-e3 fHKJsJPifLGbT6p/view?usp=sharing (Supplementary Materials Video S1)
Summary
Three-dimensional (3D) presentation of various objects is common in engineering sciences and in medical imaging to enhance visual understanding of the object. A few experiments have addressed this issue These include two different methods to create a 3D representation of the tumor by creating a model, either from a series of 2D histological slides from the resection specimen or from preoperative 2D medical images. The former method has been used in modeling colorectal carcinoma and liver [1,2], radical prostatectomy [3,4], and bladder reconstruction [5], and the latter method for modeling lungs [6], breast cancer [7], pancreatic ductal adenocarcinoma [8], rectal cancer [9], and ghost cell odontogenic carcinoma [10]. The pathologist slices the resection specimen more freely, generally using grossing directions perpendicular to each other and targeted to critical areas or to a site of specific interest
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